Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that can effectively treat severe aortic stenosis without traditional surgery. TAVR uses special tubes called catheters to guide and implant an artificial replacement valve into the diseased aortic valve, restoring healthy 
blood flow and improving heart function.

At a Glance

• Transcatheter aortic valve replacement (TAVR) is a minimally invasive procedure that can treat aortic stenosis, a potentially life-threatening condition where the aortic valve narrows, forcing the heart to work harder to pump blood to the rest of the body. 
• For patients with symptomatic aortic stenosis, aortic valve replacement is the only effective treatment. However, traditional surgical aortic valve replacement isn't a viable option for patients with severe illness.
• Transcatheter aortic valve replacement offers results equal to or better than traditional surgery. It has a lower risk of complications, shorter hospital stays and recovery times, and less pain and scarring.
• Initially used for patients deemed too high risk for open surgery, TAVR is now approved by the U.S. Food and Drug Administration (FDA) for patients with symptomatic aortic stenosis, regardless of their surgical risk.

What is Aortic Stenosis?

Aortic stenosis, or narrowing of the aortic valve, is one of the most common and serious forms of heart valve disease. It restricts proper blood flow out of the heart, leading to symptoms like shortness of breath, chest pain, and dizziness—dramatically impacting quality of life. If left untreated, aortic stenosis can quickly lead to heart failure and death. 

Once symptoms appear, replacing the aortic valve with an artificial device to restore healthy blood flow is the only effective treatment. However, traditional surgery isn't an option for many patients because it places tremendous stress on the body and carries risks of complications that increase with factors like age and other health conditions (comorbidities). 

Transcatheter Aortic Valve Replacement (TAVR)

Transcatheter aortic valve replacement (TAVR) was developed to address the need for a safe valve replacement option for these high-risk patients. Since its introduction in 2002, transcatheter valve replacement has proven to be a viable alternative to surgical valve replacement. 

The landmark Placement of AoRTic TraNscathetER Valve (PARTNER) clinical trial helped establish the safety and effectiveness of TAVR when compared to surgical valve replacement. 

What is the TAVR Device? 

The TAVR device bioprosthetic valve: a metal mesh frame that houses leaflets made from animal tissue to replicate the aortic valve's function.

The device's unique design allows it to remain elongated and collapsed as it travels through the catheter and up to the aortic valve and then expand once it is deployed and implanted. 

TAVR takes advantage of the calcium buildup around the damaged aortic valve—as the device expands, it anchors onto the calcium deposits to hold itself firmly in place. As the valve opens up, the new leaflets start to work and take over the function of the diseased valve. 

Who is a Candidate for TAVR?

The U.S. Food and Drug Administration (FDA) has approved TAVR for patients with symptomatic aortic stenosis regardless of surgical risk, and it has become widely adopted worldwide. 

TAVR is also an option for patients with failing surgically implanted valves; the device can be anchored onto the previously implanted valve without a second surgery.

How is the TAVR Procedure Performed?

At the start of a TAVR procedure, the patient is given medication to keep them calm and sedated. Unlike a surgical valve replacement, there's typically no need for general anesthesia. The patient's vital signs are carefully monitored throughout the procedure. 

• A catheter is inserted into a large artery, usually in the groin. 
• With the help of X-rays or echocardiograms, the catheter is carefully guided through the blood vessels and up into the heart. 
• The TAVR device is passed through the catheter on a guide wire to the damaged aortic valve, remaining folded and compressed until implanted.
• The TAVR device is positioned over the damaged aortic valve. 
• Once in place, the valve is deployed either by releasing it or using a special balloon to expand it, depending on the valve's design.
• Once the valve is shown to be placed correctly and functioning properly, the guide wire and catheter are removed.
• The incision site in the groin is covered with a compression bandage to prevent bleeding.
• The patient goes to the recovery room for observation. 

Patients are often up and walking around later that evening and typically go home the next day. 

What are the Benefits of TAVR?

Using a minimally invasive strategy for valve replacement has several benefits over a surgical approach:

• Less strain - Open heart surgery is very stressful for the body, especially for the very ill. By eliminating that stress, TAVR is an option for patients who might not survive surgery.
• Faster healing - Because TAVR doesn't require the chest to be opened, it eliminates the prolonged recovery period.
• Shorter hospital stays - TAVR patients regularly go home after one night of observation, while surgical procedures can require extended hospital stays.
• Fewer complications - While all heart procedures carry some risk, TAVR avoids many potential risks associated with open surgery, such as excessive bleeding or complications related to general anesthesia.
• Less scarring - Because the procedure only requires a small incision (usually in the groin area), patients don't have to worry about large, prominent scars.
• Lower cost - By avoiding extended hospital stays, costs associated with TAVR are significantly lower than surgery.

Next Steps

If you or a loved one could benefit from a TAVR procedure, we're here to help. Columbia is a world-leader for heart valve care, with the expertise and experience to support your needs for years to come. To learn more about partnering with the Columbia Structural Heart and Valve Center for your care, call us at (212) 342-0444 or complete our online application form. 

We accept most major insurance plans and can verify your plan when you call to make your appointment.